Comprehensive Medical Aid Plan

Comprehensive Medical Aid Plan – 2020 Comparisons

comprehensive medical aid plan south africa family figures stethoscopeComprehensive Medical Aid Plan: Offers unlimited hospital cover and Comprehensive Medical Aid Plan benefits.  In new generation plans, initial claims will be funded from a medical savings account.  Thereafter when all accumulated day-to-day claims reach a specified threshold, another risk benefit kicks in and continues to pay claims until the end of the year.

Traditional options have generous amounts of day-to-day cover for all the different medical providers except for GP’s consultations and conservative dentistry where cover is generally unlimited and no benefits carry forward to the next year.

View our latest 2020 plan updates below.

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Comprehensive Plans2020 Comparisons Made Easy!

DISCOVERY
CLASSIC COMPREHENSIVE - Comprehensive Plan
MONTHLY CONTRIBUTIONS
Principal Member R 5,954
Spouse/Adult Dependant R 5,633
Per Child (Max 3) R 1,188



IN HOSPITAL BENEFIT
2020 BENEFITS
200% Scheme Rate
No Overall Annual Limit
Network Hospitals to be used.
Certain procedure only covered at Network Day Clinics.
Annual Sub-limits per person:
Psychiatric Treatment
21 days
Hospice Care
R 68,100
Oncology R 400 000 thereafter 20% co-payment.
Specialised Medicine & Technology
R 200,000
Internal Prostheses: See detailed benefit schedule.
CHRONIC MEDICATION
100% Scheme Rate
27 PMB Chronic Disease Conditions.
Subject to scheme formulary.
(Additional 23 Chronic Disease Conditions)
ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Limits per annum:
Member R 17,856
Member + Spouse R 34,752
Member + Spouse + Child 1 R 38,316
Member + Spouse + Child 2 R 41,880
Member + Spouse + Child 3 R 45,444
Member + Child 1 R 21,420
Member + Child 2 R 24,984
Member + Child 3 R 28,548


Day-to-day Extender Benefit


ANNUAL THRESHOLD
Principal Member R 20,850
Spouse/Adult Dependant R 20,850
Per Child R 4,000
DISCOVERY
CLASSIC DELTA COMPREHENSIVE - Comprehensive Plan
MONTHLY CONTRIBUTIONS
Principal Member R 5,362
Spouse/Adult Dependant R 5,077
Per Child (Max 3) R 1,069



IN HOSPITAL BENEFIT
2020 BENEFITS
200% Scheme Rate
No Overall Annual Limit
Network Hospitals to be used.
Certain procedure only covered at Network Day Clinics.
Annual Sub-limits per person:
Psychiatric Treatment
21 days
Hospice Care
R 68,100
Oncology R 400 000 thereafter 20% co-payment.
Specialised Medicine & Technology
R 200,000
Internal Prostheses: See detailed benefit schedule.
CHRONIC MEDICATION
100% Scheme Rate
27 PMB Chronic Disease Conditions.
Subject to scheme formulary.
(Additional 23 Chronic Disease Conditions)
ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Limits per annum:
Member R 16,080
Member + Spouse R 31,308
Member + Spouse + Child 1 R 34,512
Member + Spouse + Child 2 R 37,716
Member + Spouse + Child 3 R 40,920
Member + Child 1 R 19,284
Member + Child 2 R 22,488
Member + Child 3 R 25,692


Day-to-day Extender Benefit


ANNUAL THRESHOLD
Principal Member R 20,850
Spouse/Adult Dependant R 20,850
Per Child R 4,000
DISCOVERY
CLASSIC PRIORITY - Comprehensive Plan
MONTHLY CONTRIBUTIONS
Principal Member R 3,814
Spouse/Adult Dependant R 3,008
Per Child (Max 3) R 1,526



IN HOSPITAL BENEFIT
2020 BENEFITS
200% Scheme Rate
No Overall Annual Limit
Network Hospitals to be used.



Annual Sub-limits per person:
Psychiatric Treatment
21 days
Hospice Care
R 68,100
Oncology R 200 000 thereafter 20% co-payment.
Internal Prostheses: See detailed benefit schedule.



CHRONIC MEDICATION
100% Scheme Rate
27 PMB Chronic Disease Conditions.
Subject to scheme formulary.

ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Limits per annum:
Member R 11,436
Member + Spouse R 20,460
Member + Spouse + Child 1 R 25,032
Member + Spouse + Child 2 R 29,604
Member + Spouse + Child 3 R 34,176
Member + Child 1 R 16,008
Member + Child 2 R 20,580
Member + Child 3 R 25,152



Day-to-day Extender Benefit


ANNUAL THRESHOLD
Principal Member R 16,900
Spouse/Adult Dependant R 12,700
Per Child R 5,600
FEDHEALTH
FLEXIFED 4 ANY - Hospital Plan/Day to Day Cover
Note: Replaced FedHealth Maxima Standard
MONTHLY CONTRIBUTIONS
Principal Member R 3,367
Spouse/Adult Dependant R 3,054
Per Child (Max 3) R 1,036



IN HOSPITAL BENEFIT
2020 BENEFITS
100% Scheme Rate
No Overall Annual Limit
Co-payments are due for certain procedures
(eg: R2 400 for Arthroscopy)
*30 days Post Hospital Cover
*7 days Take Home Medicine
*Emergency Trauma at Out Patients
Psychiatric Treatment
R 26,200
Hospice Care
R 32,300
Oncology (only at DSP)
R 464,700
Internal Prosthesis
R 26,100
CHRONIC MEDICATION
100% Scheme Rate
43 Chronic Disease Conditions.
Subject to Intermediate Scheme formulary.
Only from Medi-Rite, Clicks, Dis-Chem &
Pharmacy Direct.



ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Member
R 300
Spouse
R 264
Per Child (Max 3)
R 96
MediVault Savings amounts are not pro-rated and can be
transferred to your Wallet at any time and paid back
interest-free over a period of 12 months:
Member
Member + 1
Member + 2
Member + 2 +


Unlimited Network GP Benefit


ANNUAL THRESHOLD
Member
R 14,400
Member + 1
R 25,800
Member + 2
R 29,400
Member + 2 +
R 33,000
FEDHEALTH
MAXIMA EXEC - Comprehensive Plan
MONTHLY CONTRIBUTIONS
Principal Member R 5,992
Spouse/Adult Dependant R 5,202
Per Child (Max 3) R 1,906



IN HOSPITAL BENEFIT
2020 BENEFITS
200% Scheme Rate
No Overall Annual Limit
Co-payments are due for certain procedures
(eg: R8 200 for Arthroscopy)
*30 days Post Hospital Cover
*7 days Take Home Medicine
*Emergency Trauma at Out Patients
Psychiatric Treatment
R 33,400
Hospice Care
R 32,300
Oncology (only at DSP)
R 580,900
Internal Prosthesis
R 181,200
CHRONIC MEDICATION
100% Scheme Rate
51 Chronic Disease Conditions.
Subject to Intermediate Scheme formulary.
Only from Medi-Rite, Clicks, Dis-Chem & Pharmacy Direct
Single
R 7,400
Per Family
R 13,600
ANNUAL DAY TO DAY BENEFIT
(including Savings)
100% Scheme Rate
Limites per annum:
Member R 9,288
Member + Spouse R 17,352
Member + Spouse + Child 1 R 20,304
Member + Spouse + Child 2 R 23,256
Member + Spouse + Child 3 R 26,208
Member + Child 1 R 12,240
Member + Child 2 R 15,192
Member + Child 3 R 18,144


Unlimited Network GP Benefit






ANNUAL THRESHOLD
Principal Member
R 14,265
Spouse/Adult Dependant
R 10,954
Per Child (max 3)
R 3,669



As additional Comprehensive Medical Aid Plan comparisons are made available we will continue to update this page in our effort to provide our clients with the most up to date information and advice on the medical aid industry in South Africa. If you are still deciding which plan type is best suited to your situation, why not take a look at the Medical Aid Plans page to see the full range of plans.

For more detailed information on any of the above Comprehensive Medical Aid Plan comparisons simply contact us. If you already know what you want, why not make use of our site to download the relevant Medical Aid Application form and then fax it back to us on 0866 200 320 . Alternatively, if you would like us to confirm some of the finer details and pricing just fill in our free Medical Aid Quote Request form and we will get back to you promptly.

Finally, we invite you to contact us on +27 21 712 8866 at any point in your decision making process for further information on these Comprhensive Medical Aid Plan comparisons.

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